Individual provider Active NPI

Erica Lynne Palmisano, M.D.

  • Allergy & Immunology Physician
  • Grandville, MI
National Provider Identifier
1629367081
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
4301501657 Issued in MI
Practice address
3185 Macatawa Dr SW Ste B
Grandville, MI 49418-3184
Phone
(616) 531-6900
NPI assigned
Apr 6, 2011
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 036135083 IL
Allergy & Immunology Physician 207K00000X 4301501657 MI Primary

Addresses

Primary practice location

3185 Macatawa Dr SW Ste B
Grandville, MI 49418-3184

Mailing address

3185 Macatawa Dr SW Ste B
Grandville, MI 49418-3184
Phone (616) 531-6900

Other practice location 1

3185 Macatawa Dr SW Ste B
Grandville, MI 49418
Phone (616) 531-6900

Other identifiers 1

IdentifierTypeStateIssuer
036135083MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027000324 MI Practitioner - Allergy/Immunology 4880987106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Associates of Western Michigan P.C.Group PAC ID 1658381546, 2 clinicians

Practice addresses (Care Compare)

3185 Macatawa Dr SW B
Grandville, MI 49418-3163
Phone (616) 531-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Associates of Western Michigan P.C. Allergy & Immunology CurrentSince Aug 25, 2020 Accepting new patients

Locations

1600 E Beltline Ave NE
Ste 303
Grand Rapids, MI 49525
Phone (616) 447-2005

3185 Macatawa Dr SW
Grandville, MI 49418
Phone (616) 531-6900

3185 Macatawa Dr SW
Ste B
Wyoming, MI 49418
Phone (616) 531-6900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1629367081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3185 MACATAWA DR SW STE B",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183184",
            "telephone_number": "616-531-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 MACATAWA DR SW STE B",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183184",
            "telephone_number": "616-531-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3185 Macatawa Dr SW Ste B",
            "address_purpose": "LOCATION",
            "city": "Grandville",
            "state": "MI",
            "postal_code": "49418",
            "country_code": "US",
            "telephone_number": "616-531-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMISANO",
        "first_name": "ERICA",
        "middle_name": "LYNNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036135083",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "4301501657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036135083",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.